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General NPI Number Information
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NPI Number | 1679980692
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Entity Type | Organization
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Legal Business Name | ANDREW KIM, DO PLLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 2875 SAINT ROSE PKWY SUITE#120
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City | HENDERSON
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State | NV
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Zip | 89052-4838
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Country | US
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Telephone | 702-243-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 4616 W SAHARA AVE SUITE 261
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City | LAS VEGAS
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State | NV
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Zip | 89102-3654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW KIM
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Credential |
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Telephone | 702-756-7230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | DO1610
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License Number State | NV
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